06-104536 City of Federal Way �/
Community Development Services Plumbing Perm11. #: 06-104536-00-PL
P.O.Box 9718
Federal Way,WA 98063-9718
Ph.(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: CANNON
Project Address: 30700 19TH AVE S Parcel Number: 092104 9104
Project Description: ALT- installation of plumbing to an addition.
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Owner Applicant Contractor
ROBERT L CANNON SCOTT HARDING HARDING PLUMBING
MELANIE CANNON HARDING PLUMBING HARDIP*959LS 06-10-2007
30700 19TH AVE S 610 ALOHA ST SUITE 402 610 ALOHA ST SUITE 402
FEDERAL WAY WA 98003 SEATTLE WA 98109 SEATTLE WA 98109
Plumbing Fixtures
Bathtubs 1 Dishwashers 1 Laundry Washer Outlets 1
Lavatories 3 Showers 1 Sinks 2
Water Closets 2 Water Heaters 1 Hose Bibbs 5
PERMIT EXPIRES Saturday, September 6, 2008
Permit Issued on Thursday, September 7, 2006
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: - Date: "1'0(D
1
THIS CARD IS TO MAIN ON-SITE
CITY OFotettNtoftwo
ommunity pm Develo nt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 06-104536-00-PL
Owner: ROBERT L CANNON
Address: 30700 19TH AVE S
FEDERAL WAY, WA 98003-5103
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence On-going inspections
are logged on the back of this card.
❑ Plumbing Groundwork(4190) ❑ Rough Plumbing(4230) ❑ Gas Piping(4125)
Approved to cover ,, Approved Approved to release test
By Date By- wl Date —//— J 4 By Date
❑ Final-Plumbing (4075)
Approved
By Date
* - � yah ?E IT—
. •
� sf RECEIVED
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an,OF�' ✓
Federal Way PERMIT0 7 2006 — -
COMMUNITYDEVELOPMENT SERVICES
SF MF CO ME EL PL DE EN FP
33325 8Th AVENUE SOUTH•PO BOX 9718 r IT To
FEDERAL WAY,WA 98063-9718 A P P L I C A' `fi g Aa WAY
253-835-2607•FAX 253-835-2609 i i ►EPT.
www.cittioffedemlwao.corn
The following is required information-an incomplete application will not be acce•ted. Please print legibly in ink)or type.
w; 22 111 PROPERTY INFORMATION
SITE ADDRESS JD `-y Vv 5 • 'FrPi,_\NIY1 WA— 'gCO3 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 1 2 J_ _ it - g 'I Q LOT SIZE(sfl
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description(
r:.;■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Pro detailed description of work included on this permit onlu)
ll/ti- i(41
�
PROJECT NAME(Name of Business or Owner Last Name) CIA .iA O1
PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER MCCJ "L)O`i•k) A€370��
MAILING ADDRESS CITY,STATE,ZIP
,Dl 1913k AVE-5. - �EP.�cL o JP ' \\)4- '95Z.3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
-E)11•Jh ..aan- 1 ttQ ( tc& SSt 1813
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
610 �r ao`� n war-g 5101 ( Zob)
CITY OF FEDERAL WAY BUSINESS LICENSE NUMnR EXPIRATION DATE FAX NUMBER
B L . __
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
t+ A- R-0 A- 61 y q Ls
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
V't.I41 R-Ut oJ&" (50DTT- i- At►v�; ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
(Ci' C) Awl -3i �p2 i'C y�)�-9�►eel ( -2.6 ) _ -1585
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑ Tenant ❑Agent lkOther(Describe) tl'�Rd��� ( ) -
CONTACT NAME ] _ PRIMARY PHONE E-MAIL ADDRESS
CDCBT'T- (-�.►-e p it ( ) -
LENDER12, f>O �l a, 4 NAME
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
1
■ DETAILED BUILDING INFORMATION C „. '.,
EXISTING USE / PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPE SSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
• i
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ. FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS EXISTING PROPOSED TOTAL Z " 1 I c P ?
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBINGf
l BATHTUBS(or Tub/Shower Combo) k SHOWERS ,. WATER CLOSETS(Toilet) MISC(Describe)
I DISHWASHERS Z SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
I WASHING MACHINES URINALS 3 HOSE BIBBS
3 LAVS(Bathroom Sinks) VACUUM BREAKERS ( ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perfury that the information furnished by me is true and correct to the best of my knowledge, and further,that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to hold
harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of
such claim),which may be made by any person,including the undersigned, and filed against the City of Federal Way,but only where such claim
arises out of the reliance of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLEc5A-
DATE e• ••�D
tat re) (Title)
RELATIONSHIP TO PROJECT ❑ Owner 0 Agent Contractor 0 Architect 0 Other
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